National Provider Identifier

Tia M Mancini, PA

Tia M Mancini, PA is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Rochester, NY and a listed phone number of (585) 922-3963.

NPI 1831524123Rochester, NYSurgical Physician Assistant

Profile Overview

NPI
1831524123
Provider Type
Individual
Primary Specialty
Surgical Physician Assistant
Enumeration Date
September 05, 2013
Last Updated
May 29, 2024

Practice Location

  • 1425 Portland Ave
  • Rochester, NY 14621-3001

Phone: (585) 922-3963

Mailing Address

  • 100 Kings Hwy S
  • Rochester, NY 14617-5504

Specialties

  • Surgical Physician Assistant (363AS0400X)
Full Record
NPI
1831524123
Entity Type
Individual
Last Name
Mancini
First Name
Tia
Middle Name
M
Credential
PA
Provider Other Last Name
Hewitt
Provider Other First Name
Tia
Provider Other Middle Name
M
Provider Other Credential Text
PA
Provider Other Last Name Type Code
1
Mailing Street Address
100 Kings Hwy S
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14617-5504
Mailing Country
US
Mailing Phone
(585) 922-0553
Mailing Fax
(585) 922-0496
Practice Street Address
1425 Portland Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-3001
Practice Country
US
Practice Phone
(585) 922-3963
Practice Fax
(585) 266-5363
Enumeration Date
September 05, 2013
Last Updated
May 29, 2024
Sex
Female
Sole Proprietor
No
Certification Date
May 29, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Surgical Physician Assistant (363AS0400X)